Interferences in blood bank testing

Abstract Transfusion of blood products requires pre-transfusion testing in order to select and issue safe blood. Pre-transfusion evaluation for non-emergent blood transfusion includes a review of the patient's medical history and pre-transfusion testing. Medical history review should include clinical diagnosis, medication, potential sources for allo-immunization such as prior blood transfusion, pregnancy, hematopoietic progenitor cell (HPC) or organ transplantation, and prior blood bank (BB) history including records for clinically significant antibodies (Abs), adverse effects to blood transfusions and special transfusion requirements. The pre-transfusion testing includes (1) ABO/RhD typing and antibody screen (Ab screen) on recipient's blood sample; (2) confirmation of the ABO typing on all donor units and of the RhD type in the units labeled RhD-negative; (3) selection of appropriate ABO/Rh compatible units from the BB inventory; (4) in vitro compatibility testing or crossmatch (XM); and (5) labeling the red blood cell (RBC) units with at least two independent patient identifiers, donor unit number, and compatibility test results. The basics of BB tests and possible interferences are reviewed within this chapter and relevant clinical case-scenarios are presented.